Magnesium Citrate Colonoscopy Prep Instructions **READ INSTRUCTIONS CAREFULLY - AT LEAST 5 DAYS PRIOR TO PROCEDURE** In order for the physician to perform a colonoscopy, a bowel "cleanout" must be completed at home prior to your procedure. A bowel cleanout is a combination of a clear liquid diet and oral laxatives. All of the items can be obtained at your local pharmacy without a prescription. You will need to purchase the following: » Three 10 ounces bottles of Magnesium Citrate (liquid not pill form) » A small box of Dulcolax tablets (5 milligram tablets). NOT suppositories. » Clear liquids of your choice (see below for examples) » Baby wipes and/or Desitin or A&D ointment OPTIONAL. This helps prevent sore bottom. Do not wear ointment on bottom when you leave for procedure (obscures image) MANUFACTURER'S INSTRUCTIONS MAY DIFFER. PLEASE FOLLOW THE INSTRUCTIONS BELOW »**Contact Kayla, at physician's office, regarding any prescription blood thinners taken at home. »Discontinue any fiber supplements (Metamucil, Citrucel, Fibercon, etc.) at least five 5 days prior to procedure. »If you take narcotics, or suffer from chronic constipation, please take Miralax twice a day for five days prior to procedure. »Do not take any iron pills for 3 days prior to your colonoscopy. »It is best to eat lightly for a few days before your exam. It makes the cleanout easier and more effective. »Avoid whole wheat products and fibrous foods with skins, seeds, etc. DAY BEFORE COLONOSCOPY - Clear Liquids Only ** If you take narcotics at home, please take a bottle of Magnesium Citrate in the morning and then follow instructions below. Magnesium Citrate can be purchased over the counter at any pharmacy. 1) Upon rising in the A.M. - take 2 dulcolax tabs with water. 2) Drink only "clear liquids" for breakfast, lunch and dinner. Solid foods, milk or milk products are NOT allowed until after your procedure. A clear liquid is anything that you can see through. (Consume at least 2 liters of clear liquids this day.) Examples of "CLEAR LIQUIDS" INCLUDE: »Strained fruit juices without pulp (apple, white grape, lemonade) »Clear Ensure »Clear broth or bouillon »Coffee or tea (without milk or creamer) »Water »Kool-Aid or other fruit flavored drinks (no reds) »Gatorade, Ice Popsicles (no red) »Carbonated and non-carbonated soft drinks »Plain Jello - without added fruits or toppings (no red or purple) 3) Take your usual medicines. (follow physician's orders regarding blood thinners) 4) At 5:00 PM: Drink 1 bottle of Magnesium Citrate. Follow with 1 full glass (8 oz.) of clear liquid. Drink at least 3 more full glasses (8 oz.) of clear liquid. 5) 30 minutes after the first dose, drink the second bottle of Magnesium Citrate. Follow with 2 to 3 more glasses of clear liquid. Note: Individual responses to laxatives vary. This prep should produce multiple bowel movements. It often works within 30 minutes but may take up to 3 hours. Remain near bathroom facilities for the remainder of the evening. 6) If your procedure is scheduled for in the morning hours continue with the following steps. If your procedure is scheduled for in the afternoon hours skip to "Day of Examination" instructions below and continue drinking clear liquids throughout the evening. For procedures scheduled the next morning: » At 9:00 PM, drink 1 bottle of Magnesium Citrate and follow with one full (8 oz) glass of clear liquid. » Do NOT drink anything after midnight if your procedure is scheduled for the morning hours. 7) Diabetics may need to adjust their medications this day. Ask your prescribing physician. DAY OF EXAMINATION - Clear Liquids Only AM Procedures: Your prep was completed last night. Nothing by mouth except medications listed below. PM Procedures: At 8:00 AM, drink one bottle of Magnesium Citrate and follow with 8 oz (one full glass) clear liquid. No breakfast, food of any kind. You may have clear liquids until 3 hours prior leaving for your appointment. After this time period, you may NOT have anything by mouth.

Medications: take heart and blood pressure medications as normal. Do NOT take diabetic medications. »Plan to arrive at your scheduled arrival time. »The average length of stay is approximately 2 hours.

NOTE: The laxative prep is intended to evacuate your colon. Ideally your bowel movements, prior to leaving for your procedure, should be fairly clear. You should be able to see the bottom of the toilet. Mucous, sediment and color tint are normal. If your bowel movements are dark or have substance, please give yourself one or two Fleets enemas or call office for additional instructions. 9092020